As primary care doctors, treating patients with Type 2 DM is our bread and butter, as the majority of them seek treatment at health clinics. It is true that some of the patients have managed to achieve good glycaemic control, but more than half of them still have poorly controlled blood sugar as compared to the clinical practice guideline recommendation [1]. And usually, the first thing that comes to our mind when seeing these patients is to increase the dosage of anti-diabetic medication that they are currently on or to add another agent, including insulin. We also frequently tell them that the high blood sugar level is not surprising, as such is the nature of diabetes, where the worsening of blood sugar is expected due to progressive deterioration of pancreatic beta cell function.
INTRODUCTION: In most Asian countries, stroke is one of the major causes of mortality. A stroke event is life-changing for stroke survivors, which results in either mortality or disability. Therefore, this study comprehensively focuses on prevalence, risk factors, and secondary prevention for stroke recurrence identified in South, East, and Southeast Asian countries.
METHODS: This scoping review uses the methodological framework of Arksey and O'Malley. A comprehensive search of academic journals (English) on this topic published from 2007 to 2017 was conducted. A total of 22 studies were selected from 585 studies screened from the electronic databases.
RESULTS: First-year stroke recurrence rates are in the range of 2.2% to 25.4%. Besides that, modifiable risk factors are significantly associated with pathophysiological factors (hypertension, ankle-brachial pressure index, atherogenic dyslipidaemia, diabetes mellitus, metabolic syndrome, and atrial fibrillation) and lifestyle factors (obesity, smoking, physical inactivity, and high salt intake). Furthermore, age, previous history of cerebrovascular events, and stroke subtype are also significant influence risk factors for recurrence. A strategic secondary prevention method for recurrent stroke is health education along with managing risk factors through a combination of appropriate lifestyle intervention and pharmacological therapy.
CONCLUSION: To prevent recurrent stroke, health intervention should be geared towards changing lifestyle to embody a healthier approach to life. This is of great importance to public health and stroke survivors' quality of life.